NPI | 1366739153 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Y00000X Otolaryngology (Licence: MA 277368) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: PA MD457050) |
207Y00000X Otolaryngology (Licence: CA A 125762) | |
Enumeration Date | 2011-06-30 |
Last Update Date | 2021-05-03 |